NICOTIAN A TABACUM -711 insecticide, especially in agricultural districts. In 1926, a labourer - of Kent, who had used nicotine as an insecticide and kept it on a shelf in the kitchen with other bottles containing non-poisonous medicine, took some of the nico- tine by mistake and died immediately. The following cases are the examples of severe nicotine poisoning as a result of absorption through the skin : — 1. In the process of making an insecticide, a girl, 22 years old, accident- ally spilt about 2 drachms of a 95 per cent solution of nicotine on her overall sleeves. She changed the overall and washed her arm under the hot tap, dried herself, wiped her damp jumper sleeve, and went on with her job. Twenty minutes later she collapsed.5 2. A man, aged 35, sat down in a chair on the seat of which some " Nico-Fume Liquid" (a 4 per cent solution of free nicotine) had been spilled. He felt the solution wet through his clothes to the skin over the left buttock, an area of about the size of a palm, and recognized what it was by its characteristic odour. In about 15 minutes he was seized with severe symptoms of poisoning and recovered in 4 days.6 Soldiers sometimes apply tobacco to the skin with a view to becoming sick and thus escaping military duty. The usual method of malingering is to soak two strong cheroots in water for some hours, and to place at bed time one in each axilla, which is held in position by a bandage. The following morning poisonous symptoms supervene, so that the malingerer is unable to attend to duty. In order to ensure greater certainty of the effects, the water in which the cigars have been soaked is taken internally. Deacon7 describes the case of an Italian soldier who thus suffered from tobacco poison- ing at the time of expiry of his leave, so that he was reported sick. Suicidal and homicidal cases of tobacco poisoning are rare. Douglas Cowburn8 reports the case of a woman who took an insecticide consisting of a mixture of nicotine apparently with suicidal intent, and who was sub- sequently found dead in a field with the empty bottle by her side which had contained the poison. In the celebrated case of Count Bocarnie, nico- tine was administered to the brother of the Countess by force. Tobacco used to be a common agent for infanticide in the districts of Agra and Gwalior. It has also been employed to procure abortion. In addition to nicotine, tobacco smoke emanating from cigarettes, cigars and pipe tobacco contains carbon dioxide, carbon monoxide, hydrocyanic acid, hydrogen sulphide, ammonia and pyridine, which are responsible for the irritation of the throat and respiratory passages. Nicotine is eliminated partly by the lungs, but chiefly in the urine, the secretion of which it increases. It is also detected in the saliva and sweat. In nursing mothers who smoke excessively nicotine may be found in the breast milk. Lessage9 asserts that wet nurses who chew or smoke tobacco can poison the babies they nurse and the symptoms produced are digestive disturbances, restlessness, dyspnoea, bradycardia, syncope, collapse and death. A case10 is recorded where a breast-fed infant, six weeks old, whose mazier smoked twenty cigarettes a day, suffered from restlessness, insomnia, spastic vomiting, diarrhoea, rapid pulse and circulatory disturbances. The infant recovered after the 4. A. Douglas Cowburn, Med.-Leg. and CriminoZog. Rev., April 1933, p. 120. 5. Lockhart, Brit. Med. Jour., Feb. 11, 1933, p. 246. 6. Faulkner, Jour. Amer. Med. Assoc., May 27, 1933, p. 1664. 7. Brit. Med. Jour., July 10, 1923, p. 61. 8. Med.~Leg, and Criminology. Rev., April 1933, pp. 120-121. 9. Jour. Amer. Med. Assoc., June 6, 1926, p. 1787. 10. Wyckerheld Bisdan, Maandschrift voor Kindergeneskunde, Leyden, May 1937, p. 332; Jour, Amer. Med. Assoc., July 10, 1937, p. 178.